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胰岛素注射导致的针刺伤:亚太地区使用安全笔式针头的风险因素、问题及影响

Needlestick Injuries With Insulin Injections: Risk Factors, Concerns, and Implications of the Use of Safety Pen Needles in the Asia-Pacific Region.

作者信息

Mohamed Mafauzy, Tandon Nikhil, Kim Youngsoon, Kopp Irene, Tanaka Nagaaki, Mikamo Hiroshige, Friedman Kevin, Bajpai Shailendra

机构信息

School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.

Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Diabetes Sci Technol. 2025 Jan;19(1):169-178. doi: 10.1177/19322968231186402. Epub 2023 Jul 21.

DOI:10.1177/19322968231186402
PMID:37475682
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11688701/
Abstract

Globally, health care workers (HCWs) are at a high risk of occupational exposure to needlestick injuries (NSIs). Needlestick injuries not only are associated with an increased risk of infections caused by bloodborne pathogens but are also a primary source of emotional distress and job burnout for HCWs and patients. Insulin injection-related NSIs are common among HCWs working in hospitals in the Asia-Pacific (APAC) region and impose a significant burden. Insulin pen needles have a high risk of transmitting infections (at both the patient-end and cartridge end of the sharp) after use. Recapping a needle after administering an insulin injection poses a major risk to HCWs. Currently, several safety-engineered needle devices (SENDs) are available with active or passive safety mechanisms. Passive insulin safety pen needles with dual-ended protection and automatic recapping capabilities have resulted in a significant drop in accidental punctures to HCWs while administering insulin to patients with diabetes. In this article, we have reviewed the burden and common causes of NSIs with insulin injections among HCWs in the APAC region. We have discussed current approaches to address the issues associated with NSIs and the benefits of introducing SENDs in health care settings, including long-term care facilities, nursing homes, and home care settings where patients may require assisted insulin injections. This review also summarizes key strategies/recommendations to prevent NSIs in HCWs and patients with diabetes in the APAC region.

摘要

在全球范围内,医护人员面临针刺伤职业暴露的高风险。针刺伤不仅会增加血源性病原体感染的风险,也是医护人员和患者情绪困扰及职业倦怠的主要来源。胰岛素注射相关的针刺伤在亚太地区医院工作的医护人员中很常见,并带来了沉重负担。胰岛素笔式针头在使用后(在针头的患者端和药筒端)具有很高的感染传播风险。注射胰岛素后重新盖帽对医护人员构成重大风险。目前,有几种带有主动或被动安全机制的安全设计针头装置可供使用。具有双端保护和自动重新盖帽功能的被动式胰岛素安全笔式针头,在为糖尿病患者注射胰岛素时,已使医护人员意外穿刺的情况大幅减少。在本文中,我们回顾了亚太地区医护人员胰岛素注射针刺伤的负担和常见原因。我们讨论了当前解决针刺伤相关问题的方法,以及在医疗保健环境中引入安全设计针头装置的益处,包括长期护理机构、疗养院和患者可能需要辅助胰岛素注射的家庭护理环境。本综述还总结了亚太地区预防医护人员和糖尿病患者针刺伤的关键策略/建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/75a938f7033f/10.1177_19322968231186402-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/afca5756049d/10.1177_19322968231186402-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/e8c17de0ac7f/10.1177_19322968231186402-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/75a938f7033f/10.1177_19322968231186402-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/afca5756049d/10.1177_19322968231186402-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/e8c17de0ac7f/10.1177_19322968231186402-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2cc6/11688701/75a938f7033f/10.1177_19322968231186402-fig3.jpg

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本文引用的文献

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Comparing risk changes of needlestick injuries between countries adopted and not adopted the needlestick safety and prevention act: A meta-analysis.比较采用和未采用《针刺安全与预防法案》的国家之间针刺伤风险变化:一项荟萃分析。
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Prevalence of occupational exposure to needle-stick injury and associated factors among healthcare workers of developing countries: Systematic review.
发展中国家医护人员职业性针刺伤暴露的患病率及相关因素:系统评价
J Occup Health. 2020 Jan;62(1):e12179. doi: 10.1002/1348-9585.12179.
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Global Prevalence and Device Related Causes of Needle Stick Injuries among Health Care Workers: A Systematic Review and Meta-Analysis.全球医护人员针刺伤的发生率和器械相关原因:系统评价和荟萃分析。
Ann Glob Health. 2020 Apr 6;86(1):35. doi: 10.5334/aogh.2698.
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Anxiety and perceived psychological impact associated with needle stick and sharp device injury among tertiary hospital workers, Vientiane, Lao PDR.老挝万象市三级医院工作人员中与针和锐器伤相关的焦虑和心理影响感知。
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